孕妇血清妊娠相关血浆蛋白-A水平及其在三体综合征产前筛查中的应用  

The application of maternal pregnancy-associated plasma protein-A in prenatal screening

作　　者：吴云萍[1] 朱宝生[1] 焦存仙[2] 董旭东[2] 朱姝[1] 史纪芳[1] 刘娟[1] 苏洁[1] 

机构地区：[1]云南省第一人民医院遗传诊断中心 [2]云南省第一人民医院产科,昆明650033

出　　处：《中华妇幼临床医学杂志（电子版）》2007年第1期10-12,共3页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：云南省自然科学重点资助项目(编号:2003C0018Z)

摘　　要：目的回顾性分析妊娠相关血浆蛋白-A （pregnancy-associated plasma protein-A, PAPP-A）水平与妊娠结局的关系，探讨PAPP—A水平在三体综合征产前筛查中的应用价值，建立昆明地区单胎妊娠孕妇妊娠相关PAPP—A的正常参考值。方法采用时间分辨荧光免疫检测技术对2585例6～40孕周的孕妇血清PAPP—A含量进行检测。结果本地区正常单胎妊娠孕妇9～13孕周血清PAPP—A水平明显高于高加索人群（P〈0.001）；双胎妊娠孕妇的PAPP—A为同孕周单胎妊娠孕妇的1．79倍。在本组8例三体综合征胎儿妊娠的孕妇中，孕期血清PAPP—A中位数倍数（multiples of the median，MoM）的平均值为0．72MoM。结论有必要建立本地区正常孕妇血清PAPP—A正常中位数值，以提高产前筛查的准确性；妊娠18三体综合征、唐氏综合征胎儿的孕妇，在15～20孕周时，血清PAPP—A趋于正常。随着孕周的进展，PAPP—A又明显降低，与早孕期表现相似。18三体综合征妊娠者比唐氏综合征妊娠者的PAPP—A降低更为显著。Objective To establish the normal referential data of maternal serum pregnancyassociated plasma protein-A （PAPP-A） level in singleton pregnancy in Kunming region by reviewing the relationship of maternal serum PAPP-A level and pregnant outcome in prenatal screening program. Method To detect the PAPP-A levels of serum samples from 2 585 cases of normal singleton pregnancy from 6 gestational weeks to 40 weeks using dissociation enhanced lanthanide fluoroimmunoassay （DELFIA）. Results The medians of maternal serum PAPP-A of Chinese population in Kunming region were significantly higher than those of the Caucasian population in 9～13 gestational weeks, respectively. The average median of PAPP-A in twin pregnancy was 1.79 times compared to the median of singleton pregnancy in Kunming region （P〈0.01）. In 8 cases of trisomy pregnancy, the mean PAPP-A MoM in the second trimester was 0.72 MoM. Conclusion It is necessary to establish local referential normal PAPP-A median of local region to improve the veracity of prenatal screening. The maternal serum PAPP-A level of trisomy pregnancy in 15～20 gestational weeks intended to close the normal level, but significantly reduced as the pregnancy progress. The PAPP-A level in 18 trisomy pregnancies was much lower than that of Down＇s syndrome pregnancies.

关 键 词：妊娠相关血浆蛋白-A 产前筛查 三体综合征 

分 类 号：R714.5[医药卫生—妇产科学]